title: [Hospital discharge preparation: enhancing self-care competence of patients after minimally invasive hip arthroplasty].
abstract: Increasing numbers of hip replacement implant surgeries in Switzerland today are minimally invasive. Patients undergoing such procedures become mobile faster and are discharged from hospital to home within an average of four days. Using a qualitative descriptive design, this study examined how post-operative self-care is taught to patients in the orthopaedic department of a rehabilitation hospital after a minimally invasive hip arthroplasty and explored ways to optimise such teaching methods. Data were collected by conducting three focus groups with nine nursing professionals and expert interviews with the chief surgeon and the assigned physiotherapist. Data were analysed by using qualitative content analysis procedures. Results showed that teaching to enhance self-care competence of patients was not carried out systematically. Instead, the primary focus was to inform and prescribe rather than empower patients. Empowerment, however, would be necessary to assure adherence to the treatment regime. Hospital discharge often takes place surprisingly early and prevents assessment-based counselling of patients. The researchers concluded that the introduction of the minimally invasive surgical technique requires that the multidisciplinary rehabilitation team adapts its teaching methods. Self-care confidence in patients should be enhanced by following participatory clinical pathways. This demands modification in discharge and rehabilitation teaching plans to make them patient-oriented, and the plans should be supported by the entire team and the management.
authors.affiliation: Fachhochschule Kalaidos, Zürich/UniversitätsSpital Zürich.
authors.forename: Marianne
authors.initials: M
authors.lastname: Schärli
authors.forename: Virpi
authors.initials: V
authors.lastname: Hantikainen
authors.forename: Iren
authors.initials: I
authors.lastname: Bischofberger
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000451:nursing* / Q000534:rehabilitation; D015400:Clinical Nursing Research; D003299:Cooperative Behavior; D004434:Early Ambulation / Q000451:nursing; D057220:Health Literacy; D006801:Humans; D033183:Interdisciplinary Communication; D007902:Length of Stay; D019060:Minimally Invasive Surgical Procedures / Q000451:nursing* / Q000534:rehabilitation; D010348:Patient Care Team; D010351:Patient Discharge; D010358:Patient Participation; D011209:Power, Psychological; D012648:Self Care; D013557:Switzerland
keywords: Empowerment; Entlassungsplanung; Selbstpflegekompetenz; discharge planning; empowerment; minimal-invasive Hüftendoprothetik; minimally invasive hip arthroplasty; self-care competence